Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada.
Department of Pediatrics, Ophthalmology and Pharmacology, CHU Sainte-Justine Research Center, Montreal, QC, Canada.
Front Cell Infect Microbiol. 2021 Aug 19;11:660983. doi: 10.3389/fcimb.2021.660983. eCollection 2021.
In preparation for delivery, the uterus transitions from actively maintaining quiescence during pregnancy to an active parturient state. This transition occurs as a result of the accumulation of pro-inflammatory signals which are amplified by positive feedback interactions involving paracrine and autocrine signaling at the level of each intrauterine cell and tissue. The amplification events occur in parallel until they reach a certain threshold, 'tipping the scale' and contributing to processes of uterine activation and functional progesterone withdrawal. The described signaling interactions all occur upstream from the presentation of clinical labor symptoms. In this review, we will: 1) describe the different physiological processes involved in uterine transition for each intrauterine tissue; 2) compare and contrast the current models of labor initiation; 3) introduce innovative models for measuring paracrine inflammatory interactions; and 4) discuss the therapeutic value in identifying and targeting key players in this crucial event for preterm birth.
为分娩做准备时，子宫会从妊娠期间保持静止的活跃状态转变为分娩活跃状态。这种转变是由于促炎信号的积累所致，这些信号通过涉及每个子宫内细胞和组织的旁分泌和自分泌信号的正反馈相互作用得到放大。这些放大事件同时发生，直到达到一定的阈值，即“打破平衡”，并导致子宫激活和功能性孕酮撤退的过程。所描述的信号相互作用都发生在临床分娩症状出现之前。在这篇综述中，我们将：1）描述每个子宫内组织中子宫过渡涉及的不同生理过程；2）比较和对比当前的分娩启动模型；3）介绍测量旁分泌炎症相互作用的创新模型；4）讨论在识别和靶向这一对早产至关重要的事件中的关键参与者方面的治疗价值。
